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EP1551320B1 - Orthopädische fixationseinrichtung - Google Patents

Orthopädische fixationseinrichtung Download PDF

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Publication number
EP1551320B1
EP1551320B1 EP02807751A EP02807751A EP1551320B1 EP 1551320 B1 EP1551320 B1 EP 1551320B1 EP 02807751 A EP02807751 A EP 02807751A EP 02807751 A EP02807751 A EP 02807751A EP 1551320 B1 EP1551320 B1 EP 1551320B1
Authority
EP
European Patent Office
Prior art keywords
cam
mounting body
clamping
bone screw
rotation axis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP02807751A
Other languages
German (de)
English (en)
French (fr)
Other versions
EP1551320A1 (de
Inventor
Ulrich Kramer
Jörg Schumacher
Jeffrey Kozak
Rudolf Beisse
Michael Potulski
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Aesculap AG
Original Assignee
Aesculap AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Aesculap AG filed Critical Aesculap AG
Publication of EP1551320A1 publication Critical patent/EP1551320A1/de
Application granted granted Critical
Publication of EP1551320B1 publication Critical patent/EP1551320B1/de
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7041—Screws or hooks combined with longitudinal elements which do not contact vertebrae with single longitudinal rod offset laterally from single row of screws or hooks

Definitions

  • the invention relates to an orthopedic fixation device for fixing a rod-shaped fixing element with two mutually movable, at Approaching the fixing between clamping jaws.
  • the rod-shaped Insert fixing element from above between the two clamping jaws and then simply fix it by the fact that the eccentric body twisted becomes. Complicated screwdriving with many turns are on this Way not necessary, so that even through small body openings these processes can be done easily.
  • the handling of the eccentric body can be further simplified in that the possibility of twisting the Exzenter stressess is limited, for example by attacks in the clamping direction and / or in the release direction. This will on the one hand the surgeon signals whether a complete tension or solution of the eccentric body On the other hand, an overvoltage is prevented, if necessary could lead to damage to the device. The limit can be made by stops.
  • the eccentric body is rotatably mounted on a rotationally symmetrical bearing body, at which also the jaws are held.
  • the axis of rotation of the eccentric body may preferably be parallel to the axis of the rotationally symmetrical bearing body run, in particular, the axis of rotation of the eccentric body with the Axle of the rotationally symmetrical bearing body identical.
  • the rotationally symmetrical bearing body for example, circular cylindrical be formed, but it is also possible, this bearing body, for. spherically or conical. It is particularly advantageous if the bearing body it is formed by the shank of a bone screw or a hook It is then sufficient to have jaws and eccentric bodies on this shaft postpone and twist the eccentric body around the bearing body to assemble and fix the fixation device. This fixation can be both a fixation against a twist and opposite be an axial displacement.
  • the carrier is rigid with the Bearing body connected, in such an embodiment, the clamping jaws essentially only in the clamping direction against each other.
  • the carrier is about the axis of symmetry the rotationally symmetrical bearing body rotatably held on this.
  • the Clamping jaws can not only be stretched against each other, but also be twisted together about the axis of the bearing body. This results inevitably in this embodiment during rotation of the eccentric body not only a clamping of the rod-shaped fixing element on the bearing body between the jaws, but in addition a fixing the rotatably mounted on the bearing body carrier, since the eccentric body is supported on the bearing body and thereby the carrier against jammed the bearing body.
  • the carrier can in the direction of the axis of rotation on the rotationally symmetric Bearing body be pushed, so that a particularly simple installation of the implant, it is sufficient, for example, for a bearing body, which is formed by the shaft of a bone screw, the carrier from the top to postpone on the bone screw, in the extension direction Then, a tool can be introduced with which the eccentric body is adjusted, this is only a very small body opening necessary.
  • the fixed jaws can be rigidly connected to the carrier be.
  • an embodiment in which the Jaws around a parallel to the clamping direction of the jaws running Pivot axis are pivotally connected to the carrier.
  • the direction of the rod-shaped Fixing elements is adjustable relative to the bearing body.
  • a stop for the fixed jaws is that of a displacement of the fixed jaw in the direction of Fulcrum of the jaw and thus a removal of the fixed jaw bounded by the axis of rotation of the eccentric body.
  • the jaws against the carrier to the parallel to the clamping direction extending axis of rotation freely rotatable, as long as the eccentric body not curious.
  • the axis of rotation of the jaws and the axis of rotation of the eccentric body can lie in one plane, in a modified embodiment can but also be provided that the axis of rotation of the jaws and the Rotary axis of the eccentric body are laterally offset from each other.
  • the rotary joint two bayonet-like interlocking include bearing members that are in a certain angular position do not reach behind and then axially against each other. Twisted For example, you could carrier and jaws 90 ° against each other, could they are axially displaceable against each other, in a parallel orientation against it Both bearing members are fixed together in the axial direction, so that then a rotary joint is created, which over a certain angular range can not be solved, but only if the two bearing members pivoted back into the mutually perpendicular starting position become.
  • the eccentric body can rest directly on the movable clamping jaws, but it may be advantageous if between the eccentric body and the jaws an intermediate member is arranged, which at the Twisting the eccentric body more or less against the jaws is moved.
  • this intermediate member may be designed so that at opposite the carrier rotatable jaws in different Angular position of the jaws is ensured that the eccentric body over the intermediate link, the clamping force on the movable jaws can transfer.
  • the intermediate member may be movably supported on the carrier, in particular it is advantageous if the intermediate member via a resilient connection to the Carrier is held.
  • the eccentric body may be formed as a ring.
  • eccentric body recesses for receiving a Turning tool has, for example edge recesses, in the projections a rotary tool can engage positively.
  • the bearing body can be part of a bone screw or a hook, for example, the bearing body by a cylindrical Shank of a bone screw or a hook are formed.
  • a particularly advantageous embodiment results when the bearing body is connected via a cross member with a bone screw whose Longitudinal axis parallel to the longitudinal axis of the bearing body and laterally offset this runs.
  • a cross member results in relation to a in the bone screw screwed in an additional possibility of variation the positioning of the bearing body, the cross member can namely be twisted on the bone screw and in different angular position or be moved in the axial direction, so that a optimal adaptation to the anatomical conditions is possible.
  • the bone screw in the cross member to its longitudinal axis rotatable and in a certain angular position and / or can be fixed in a specific axial position. This definition may preferably done by clamping.
  • a clamping piece against the bone screw displaced be.
  • a particularly simple structure is obtained when the displacement of the Clamping piece in the cross member an adjacent to the clamping piece, about an axis of rotation rotatable eccentric is mounted. If you twist this eccentric, so he moves the clamping piece into the clamping position, and the bone screw and the cross member are no longer mutually rotatable, but solid connected with each other. Again, the rotational movement of the eccentric limited be, in particular by attacks, so that an overvoltage avoided and also the handling for the surgeon is facilitated.
  • the axis of rotation of the eccentric is preferably perpendicular to the plane of the Crossbeam.
  • the axes of rotation of the eccentric in the cross member and the eccentric body can parallel to each other, in particular, these axes of rotation may coincide.
  • the axis of rotation of the eccentric and the longitudinal axis of the bone screw be arranged in parallel, but it is in a particular embodiment also possible that the bone screw by a spherical connection is pivotally connected to the cross member and the clamping piece when fixing in the direction of a spherical bearing surface of the bone screw is displaceable. In this case, therefore, bone screw opposite be pivoted the axis of rotation of the eccentric.
  • the bearing body a fixedly connected to the cross member Be sleeve, through which a tool for rotating the eccentric can be used.
  • the eccentric may for example be a rotatable in the cross member ring, which is arranged at the cross member end of the sleeve.
  • the eccentric on one in the sleeve rotatably mounted core is arranged, at least over a part its length extends within the sleeve.
  • the bearing body is in the cross member about its Rotatable longitudinal axis and even carries the eccentric.
  • the rotary joint between Determining the crossbeam and bone screw by tensioning the eccentric before you on the bearing body itself the there rotatable eccentric body twisted to tension the jaws in the clamping position.
  • the eccentric may be fixed in the cross member in the axial direction.
  • the orthopedic fixation device 1 shown in FIGS. 1 to 8 is in the embodiment of Figure 1 on the shank of a bone screw. 3 on the other hand, in the embodiment of FIG. 2, a sleeve-shaped, cylindrical bearing body 4, which is laterally offset via a cross member 2 is arranged on the bone screw 3.
  • a sleeve-shaped, cylindrical bearing body 4 which is laterally offset via a cross member 2 is arranged on the bone screw 3.
  • both the Shank of the bone screw 3 and the cylindrical bearing body 4 of the Cross member 2 together referred to as bearing body 4, but it is understood that the described orthopedic fixation device 1 on the most diverse pen, shaft, or sleeve-shaped bearing body are placed can.
  • a carrier 5 is pushed from the top, which tightly surrounds the bearing body 4 and is freely rotatable on this.
  • This Carrier 5 has a transversely to the longitudinal direction of the bearing body 4 protruding from it Bearing shaft 6, over its length a circumferential groove 7 with arcuate Cross section and at its free end in one on opposite Side flattened annular flange 8 ends.
  • a substantially U-shaped clamping body 9 is pushed with two substantially parallel side walls, the two jaws 10, 11 form. These are the side walls in the area above the bearing shaft 6 shell-shaped on opposite sides formed so that they between them a rod-shaped fixing member 12th can receive, which arranged transversely to the longitudinal direction of the bearing shaft 6 is.
  • the two jaws 10 and 11 are through an incision thirteenth in which they connecting web 14 of the clamping body 9 against each other resiliently formed so that the fixing member 12 from above elastically between the two Clamping jaws 10, 11 can be snapped. In this snapped State immerses the fixing member in the circumferential groove 7 of the bearing shaft 6 ( Figure 4).
  • the annular flange 8 of the bearing shaft 6 is located on the outside of the clamp body 9 and thus prevents removal of the Clamping body 9 of the bearing shaft. 6
  • the bearing bore 15 is formed so that at a rotation of the clamping body 9 relative to the carrier 5 by 90 ° pulling off the clamping body. 9 can be made from the bearing shaft 6, this is by the side Flattening on the annular flange 8 of the bearing shaft 6 allows. You get thus a bayonet-type locking; by a deformation of the annular flange can after placing the clamp body 9 a permanent, a deducting preventing fixing of the clamping body 9 on the bearing shaft 6 achieved become.
  • This eccentric body 16 is at his upper edge provided with axial cuts 17, in which a in the drawing not shown rotary tool can intervene, with the help of the Exzenter stresses 16 can be rotated about the bearing body 4.
  • the legs 21 and 22 form a substantially semicircular inner Contact surface 24, which surrounds the eccentric body 16.
  • the eccentric body 16 In a release position, the eccentric body 16 is the least far in the direction on the jaws 10, 11 in front. However, if the eccentric body 16 is twisted, its scope is increasingly pushing towards the jaws 10, 11 before and shifts the intermediate piece 18 in the direction of the Jaws 10, 11. This will cause the jaws 10, the following is referred to as a movable jaws, in the direction of the opposite Jaws 11 shifted, which in the following as firm Jaws is called.
  • the movable jaw 10 applies the rod-shaped fixing member 12 and moves it in the direction of the fixed jaws 11, thereby at the same time the clamping body 9 against pressed the annular flange 8.
  • the eccentric body 16 is supported on the Bearing body 4 from, and as a result of this voltage of the eccentric 16th All degrees of freedom of the device described by clamping locked.
  • the clamping body 9 is due to the strong contact with the annular flange 8 fixed against rotation about the axis of the bearing shaft 6, the Fixing member 12 is between the two mutually tensioned jaws 10, 11 fixed, and the carrier 5 is by the plant of the eccentric body 16 on the bearing body 4 against rotation about the bearing body. 4 secured. So you get alone by rotation of the eccentric 16th a definition of four different degrees of freedom described Arrangement. It is important that this determination be made from above can, as well as the fixing member 12 from above between the still untightened jaws 10, 11 can be introduced snapping. The surgeon thus has the opportunity to take all the essential steps to assemble and for fixing the fixation device 1 by a very small Access opening from above to make.
  • the fixation device via a Cross member 2 held on the bone screw 3.
  • this cross member 2 as a flat, strip-shaped Plate trained and carries itself over a large part of its length extending slot 25.
  • the bone screw is the third through, also in this slot 25 on the opposite Side thereof an eccentric 26 rotatably mounted.
  • a clamping piece 27 which is located both on the bone screw 3 and the eccentric 26 is supported.
  • the bone screw has the third in the region of the cross member 2 a cylindrical outer shaft, in the embodiment Figure 19, which is otherwise constructed the same, is the bone screw 3 spherically formed in this area and is between the Clamping piece 27 on the one hand and the cross member 2 on the other hand axially immovable, but freely swiveling, held. If the clamping piece 27 at Tensioning of the eccentric 26 is displaced against this spherical bearing area 31, so will the different pivoting direction of the bone screw 3 permanently fixed in the cross member 2.
  • the embodiment of Figure 20 largely corresponds to that of the figures 15 to 18, corresponding parts therefore carry the same reference numerals. While the eccentric 26 in the embodiment of Figures 15 to 18 is annular, is in the embodiment of Figure 20 an eccentric 16 in the form of a rotatable core 32 used in his lower, arranged in the cross member 2 area the eccentric 26 is formed. The core 32 can be rotated by a tool that form fit from above connected to this.
  • the core 32 can itself form the bearing body 4, on which the fixation device 1 is fixed, but it can also be provided that the bearing body 4 is formed as a sleeve which is firmly connected to the cross member 2 is, as shown in the embodiment of Figure 21, which otherwise corresponds to the embodiment of Figure 20.
  • a rotary tool 30 in the interior of the hollow bearing body 4 are intervened.
  • an anvil tool 34 is provided, for example in the form of a the bearing body 4 attachable sleeve, which with projections 35 in corresponding Recesses 33 of the bearing body 4 engages positively. On this way it is possible without transfer of torques to the Cross member 2 to rotate the core 32 relative to the bearing body 4 and thereby to bring the eccentric 26 in the clamping position.
  • the bone screw 3 of the embodiments described above can also be replaced by a hook 36, which has a bony structure embraces.
  • This hook can by means of a shank-shaped shell as well a cross member 2 or a carrier 5 wear as the bone screw, only The connection to the bone is not via a thread, but via a hook-shaped end. This replacement is common to all of the above Embodiments possible.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)
EP02807751A 2002-09-04 2002-09-04 Orthopädische fixationseinrichtung Expired - Lifetime EP1551320B1 (de)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2002/009878 WO2004021901A1 (de) 2002-09-04 2002-09-04 Orthopädische fixationseinrichtung

Publications (2)

Publication Number Publication Date
EP1551320A1 EP1551320A1 (de) 2005-07-13
EP1551320B1 true EP1551320B1 (de) 2005-12-07

Family

ID=31970244

Family Applications (1)

Application Number Title Priority Date Filing Date
EP02807751A Expired - Lifetime EP1551320B1 (de) 2002-09-04 2002-09-04 Orthopädische fixationseinrichtung

Country Status (6)

Country Link
US (1) US7591838B2 (es)
EP (1) EP1551320B1 (es)
AU (1) AU2002368220A1 (es)
DE (1) DE50207041D1 (es)
ES (1) ES2253588T3 (es)
WO (1) WO2004021901A1 (es)

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US7569061B2 (en) 2004-11-16 2009-08-04 Innovative Spinal Technologies, Inc. Off-axis anchor guidance system

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DE50207041D1 (de) 2006-07-06
US7591838B2 (en) 2009-09-22
EP1551320A1 (de) 2005-07-13
WO2004021901A8 (de) 2004-06-10
AU2002368220A1 (en) 2004-03-29
ES2253588T3 (es) 2006-06-01
WO2004021901A1 (de) 2004-03-18
US20060004360A1 (en) 2006-01-05

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